Organization
COLORADO SPRINGS EYE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE MCDERMOTT (PATIENT ACCOUNT MANAGER)
(719) 636-3937
Entity
Organization
Contact information
Practice address
2920 N CASCADE AVE, SUITE 101, COLORADO SPRINGS, CO 80907-6262
(719) 636-5054
(719) 580-3576
Mailing address
2920 N CASCADE AVE, SUITE 101, COLORADO SPRINGS, CO 80907-6262
(719) 636-5054
(719) 580-3576
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4510004
—
CO
01
—
490001964
RAILROAD MEDICARE
CO
01
—
CO00357
BLUE CROSS BLUE SHIELD
CO
Enumeration date
04/21/2006
Last updated
03/11/2011
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